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Sexual Adverse Effects and Erectile Dysfunction During Buprenorphine/Naloxone Combination Treatment for Opioid Use Disorders

Authors Bestepe EE, Tunali N, Sarıdoğan GE

Received 13 August 2020

Accepted for publication 15 October 2020

Published 12 November 2020 Volume 2020:16 Pages 2695—2705


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Roger Pinder

Engin Emrem Bestepe, Nazlı Tunali, Gökçe Elif Sarıdoğan

Department of Psychiatry, Erenkoy Mental Health and Neurological Diseases Training and Research Hospital, University of Health Sciences, Istanbul, Turkey

Correspondence: Gökçe Elif Sarıdoğan
Department of Psychiatry, Erenkoy Mental Health and Neurological Diseases Training and Research Hospital, University of Health Sciences, Sinan Ercan Cad. No: 23 Kazasker, Istanbul 34736, Turkey
Tel +90 532 503 27 97

Background and Objectives: Compliance and maintenance of abstinence is a major issue in substance use disorders. Adverse effects of opioid maintenance treatments (OMT) include sexual dysfunctions. There is a vast amount of studies regarding sexual adverse effects of conventional OMTs; however, information regarding buprenorphine/naloxone (Bup/Nal) combination is limited, mostly evaluated in western populations and controversial. In this study, we aimed to assess the sexual adversities of Bup/Nal treatment in a Turkish alcohol and substance use disorder treatment center sample.
Materials and Methods: We recruited 100 subjects continuing sublingual Bup/Nal combination and 35 control subjects. Subjects were evaluated via the the Golombok-Rust Inventory of Sexual Satisfaction (GRISS) for sexual dysfunction and for erectile dysfunction (ED) with the International Index of Erectile Function-5 (IIEF-5) as a comparison.
Results: The mean dose of our treatment was 9.05. Overall sexual dysfunction scores were not significantly different in between groups with GRISS. ED and noncommunication scores were significantly higher in the Bup/Nal treatment group than the control group (p = 0.002, p = 0.02, respectively). Along with the increased ED scores in GRISS, IIEF-5 total scores also revealed more significant severity of the ED in the Bup/Nal group (p = 0.001).
Conclusion: Buprenorphine/naloxone combination lead to a higher degree of ED severity than the non-treatment controls. Noncommunication seems to play a role as a risk factor for ED in patients with opioid use disorder. Thus, effective communication can be a key factor for sexual assertivity and disclosing the sexual adverse effects to the clinicians as well as staying in the treatment.

Keywords: buprenorphine maintenance, Turkey, substance-related disorders, men, methadone

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